Analysis of 4931 renal biopsy data in central China from 1994 to 2014.

The purpose of this study is to investigate the changing spectrum and clinicopathologic correlation of biopsy-proven renal diseases in central China. We retrospectively analyzed data of 4931 patients who underwent renal biopsy in ten hospitals between September 1994 and December 2014. Among them, 81.55% were primary glomerular diseases (GD), and 13.02% were secondary GD. IgA nephropathy (IgAN) was the most common primary GD (43.45%), followed by focal glomerulonephritis (16.79%), mesangial proliferative glomerulonephritis (MsPGN, 14.35%), and membranous nephropathy (MN, 13.28%). IgAN was leading primary GD in patients under 60 years old, while MN was the leading one over 60 years old. The most frequent secondary GD was lupus nephritis (LN) (47.35%). The prevalence of IgAN, MN and minimal change disease was found to increase significantly (p < 0.001, p < 0.001, and p < 0.01, respectively), while that of MsPGN, membranoproliferative glomerulonephritis and LN decreased significantly (p < 0.001, p < 0.001, and p < 0.05, respectively). The main indication for renal biopsy was proteinuria and hematuria (49.03%), followed by nephrotic syndrome (NS, 20.36%). IgAN was the most common cause in patients with proteinuria and hematuria, chronic-progressive kidney injury, hematuria and acute kidney injury; and MN was the leading cause of NS. Primary GD remained the predominant renal disease in central China. IgAN and LN were the most prevalent histopathologic lesions of primary and secondary GD, respectively. The spectrum of biopsy-proven renal disease had a great change in the past two decades. Proteinuria and hematuria was the main indication for renal biopsy.

[The detection of flavonoids glycosides from ginkgo biloba based on spectrofluorimetry].

Flavonoids glycosides from ginkgo are widely applied in pharmaceutical, food, daily necessities and other areas due to their variety of biological activities. To overcome the shortcoming of current methods of time wasting, complex operation and expensive costs, an accuracy, low costs and fast determination method was established for flavonoids glycosides from ginkgo. According to the principle that flavonoids can form fluorescent chelate with Al3+, the detection condition was explored with rutin as standard. The results showed that the fluorimetric intensy of chelate of rutin with Al3+ would be stabilized and achieve maximum with lambda(ex) = 400 nm and lambda(em) = 520 nm, in Al (NO3)3-(HAc-NaAc) reaction system for 1 500 s with pH 3.6. The linear regression equation y = 29.92x + 36.49 (R2 = 0.986) was deduced with the concentration of rutin and fluorescence intensy, and the linear range 1.8 x 10(-6) -3.2 x 10(-5) mol x L(-1). Flavonoids glycosides of cell suspension cultures from ginkgo biloba was detected by this method. The recovery experiments were also carried out with the average recovery rate of 101.3%. The advantages of high sensitivity, reproducibility, simple operation, and low costs were showed, indicating its good prospects.

[Effect of kurarinone on renal tubular epithelial cell-mesenchyma trans-differentiation in rats with renal interstitial fibrosis].

OBJECTIVE: To study the effect of Kurarinone on renal tubular epithelial cell-mesenchyma (ECM) trans-differentiation in rats with renal interstitial fibrosis and to explore its possible mechanisms. METHODS: The rat model of renal interstitial fibrosis was established by unilateral ureteral obstruction (UUO). Sprague-Dawley male rats were randomly divided into 3 groups, the sham-operated group, the UUO group and the Kurarinone treated group (KTG). Rats in the KTG were intraperitoneally injected with Kurarinone 100 mg/kg daily after modeling. Five rats of each group were killed respectively at day 7, 14 and 21 after UUO. The serum levels of blood urea nitrogen (BUN), serum creatinine (SCr), total protein (TP) and albumin (ALB), 24-h urinary protein excretion in rats were measured. Pathological changes of renal tissue were observed by PAS and Masson stain. The expression of transforming growth factor beta1 (TGF-beta1), Smad3, alpha-smooth muscle actin (alpha-SMA) and collagen I (Col I) in kidney were determined with immunohistochemistry. And the expressions of TGF-beta1 and alpha-SMA mRNA in renal tissue were determined using reverse transcription polymerase chain reaction (RT-PCR). RESULTS: The expression of TGF-beta1, Smad3, alpha-SMA and Col I in the KTG was significantly decreased as compared with that in the UUO group respectively, and the degree of tubular damage and renal interstitial fibrosis was also ameliorated more obviously in the KTG. The TGF-beta1 and alpha-SMA mRNA expressions in KTG were significantly lower than those in the UUO group determined at the corresponding time points (P < 0.05). CONCLUSION: Kurarinone could down-regulate the expression of TGF-beta1 and Col I, inhibit EC-M trans-differentiation, suppress the activation and proliferation of myofibroblast. The probable pathway may be by way of down-regulating Smad3 expression to interfere its induction on intercellular signal transduction and consequently ameliorate renal interstitial fibrosis.

Effects of mycophenolic acid on high glucose-induced expression of TGF-beta and CTGF in mesangial cells.

The effects of mycophenolic acid (MPA) on high glucose-induced expression of transforming growth factor-beta (TGF-beta) and connective tissue growth factor (CTGF) in mesangial cells (MC) were investigated. Rat MC were cultured in the presence of different concentrations of MPA (1.0 and 10.0 micromol/L) or MPA plus high glucose for 72 h. The expression of TGF-beta and CTGF was detected by Western blot. The results showed that high glucose could induce the expression of TGF-beta and CTGF in MC, but MPA could inhibit this effects. MPA did not influence the expression of TGF-beta and CTGF in normal glucose. It was concluded that MPA might prevent the progression of diabetic nephropathy by inhibiting the expression of TGF-beta and CTGF in MC.

The p53-mediated apoptosis in hypercholesterolemia-induced renal injury of rats.

The apoptosis and the expression of tumor suppressor gene p53 in hypercholesterolemia (HC)-induced renal injury were investigated in rats. A high cholesterol diet (HCD)-induced HC rat model was made and serum lipid, urinary protein excretion (UPE) and N-aceto-beta-D-glucosidase (NAG) were measured. The levels of malondialdehyde (MDA), as an index of lipid peroxidation, in renal cortex and serum were compared between the two diet groups. Apoptosis and p53 expression were determined by TUNEL and immunohistochemistry, respectively. In the HCD-induced HC group, serum total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C) as well as triglyceride (TG) were significantly increased, while the level of high density lipoprotein-cholesterol (HDL-C) decreased. Meanwhile, increased excretions of UPE and NAG in urine were observed, which were accompanied with a decrease in urinary creatinine clearance (Ccr) and indicated both glomerular and tubular damages. In addition, apoptotic cell death coexisted in the kidney, as revealed by increased TUNEL positive cells. Finally, an increase in p53 expression was observed in tubuli, but not in glomeruli. Both TUNEL, positive cells and p53 expression were found to be correlated to the level of renal cortical MDA (r = 0.817, P < 0.01 and r = 0.547, P < 0.01, respectively). The major manifestation of HCD-induced renal injury is apoptosis. The lipid peroxidation is a critical event to induce DNA damage and p53 is involved in the pathogenesis of lipid-induced renal injury.

Nutcracker phenomenon in combination with glomerular nephritis in isolated hematuria patients.

OBJECTIVES: This study aims to analyze the relationship between nutcracker syndrome (NCS) and nutcracker phenomenon (NCP) in glomerular nephritis (GN) of patients with symptom of isolated hematuria. Our observations reveal that patients with combined GN and NCP/NCS have dysmorphic urine red blood cells or mixed-morphological urine red blood cells while patients with NCS only (without GN) contain isomorphic urine red blood cells. PATIENTS AND METHODS: Clinical and pathological data of 32 patients with NCP and complicating GN were analyzed. A different group of 17 patients with NCS served as the control. All patients underwent color Doppler ultrasonography. Routine urine examination, red blood cell counts, and phase observations of urinary sediments were performed both before and after exercise. twenty four hour urinary protein and albumin quantities were determined. Twenty-nine patients underwent renal needle biopsy. RESULTS: All 32 patients were diagnosed with NCP. Results of urinary sediment examination of patients were either normal or showed isomorphic hematuria before exercise. Most patients exhibited mixed-morphological or dysmorphic hematuria at different degrees after exercise. Renal pathological findings in 29 patients included multiple types and showed no relevance to urinary examination results. All patients diagnosed with GN complicated by NCP were identified through clinical and laboratory examinations and renal biopsy. CONCLUSIONS: NCP may coexist with a glomerular disease. NCS patients with urine red blood cells of mixed morphology or showing dysmorphism after exercise should be noted, with or without the coexistence of GN. Renal needle biopsy must be performed when necessary to avoid adverse effects on the patient's condition.

TJ0711, a novel vasodilatory ß-blocker, protects SHR rats against hypertension induced renal injury.

Previous studies suggested that ß-blockers with adjunctive α1-blocking activities warrant renoprotective function other than the therapeutic effect on hypertension. The current report is designed to dissect the role of TJ0711, a novel ß-blocker with a 1:1 ratio for the ß1/α1 blocking activities, in renoprotection in SHR rats. It was noted that TJ0711 possesses similar potency for control of blood pressure as that of Carvedilol. However, TJ0711 is much more potent in terms of protecting SHR rats against hypertension induced renal injury. Specifically, SHR rats treated with 20mg/kg/day of TJ0711 manifested significantly lower levels for urine albumin and total protein. In line with these result, TJ0711 treated rats displayed much less severe pathological changes in the kidneys. Mechanistic studies revealed that TJ0711 improves kidney perfusion during the course of hypertensive insult by enhancing eNOS expression through suppressing inflammatory cytokine secretion. TJ0711 also attenuates Vasohibin-1 expression to prevent HIF-1α from signal-induced degradation, and by which it promotes HO-1 expression to protect SHR rats against oxidative stress induced by hypertension in the kidneys. Together, our data suggest that TJ0711 possesses higher potency for renoprotection while manifesting the similar effect on hypertension therapy as Carvedilol.